| NPI | 1568423515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OK 22805) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 22805) |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2024-06-24 |